John - I have been trying to reply to you about your Parkinson Care Series,
but my emails to you all come back undeliverable, no transport provider.  If
you see this, email me off list ([log in to unmask]) and send your
address again.  We did send your series, and it hasn't come back, but I will
send another one.  Get back in touch, and understand that I can't seem to
email you back for some reason! Sorry, Meg
-----Original Message-----
From: Parkinson's Information Exchange Network
[mailto:[log in to unmask]]On Behalf Of Peggy Willocks
Sent: Wednesday, March 16, 2005 4:45 AM
To: [log in to unmask]
Subject: Re: (my progress report) / AMANTADINE... ? / calibration


Hilary
have you tried memantine (Namenda), an Alzheimer's drug found to help some
dyskinesia? Or try to find out more about Tetrabenazine, a drug from Europe,
Australia or Canada. Namenda for dyskinesia use is in Phase III trials in
the US.  A contact would be Joseph Jankovic, MD, Professor of Neurology,
Director, Parkinson's Disease Center and Movement Disorders Clinic,
Department of Neurology, Baylor College of Medicine, Houston, Texas Also,
the jury is still out on  riluzole, but worth checking into.
Peggy Willocks (See current articles below).
#####

Memantine can relieve certain symptoms in Parkinson disease. Improvement
achieved in two out of three described cases with dyskinesia and cognitive
failure (2004)
Lokk J.
Parkinson's disease is a chronic, progressive, neurodegenerative disease
with a reduction of dopamine levels causing the typical symptoms tremor,
hypokinesia, rigidity, and postural disturbance. After some years with
Parkinson's disease patients tend to develop fluctuating symptoms and
dyskinesia with involuntary movements--a state difficult to manage.
Different pharmacological as well as non-pharmacological strategies are used
and being tried. One of these is targeting the dysfunctioning glutamatergic
neurotransmitter system through the NMDA-receptors. The NMDA-receptor
antagonist amantadine has long been used as an anti-Parkinson drug but also
as an anti-dyskinetic drug. Recently, another NMDA-receptor antagonist,
memantine, was approved for moderate to severe Alzheimer's dementia in
Sweden. We describe the use of memantine on three cognitively impaired,
dyskinetic Parkinsonian patients where two seemed to benefit from this
medication regarding their dyskinesia.
Pub-Med
PMID: 15232837
#####
Effect of riluzole on dyskinesia and duration of the on state in Parkinson
disease patients: a double-blind, placebo-controlled pilot study.(2004)

Braz CA, Borges V, Ferraz HB.
Movement Disorders Unit, Department of Neurology, Universidade Federal de
Sao Paulo, Brazil.

The objective of this study was to evaluate the effect of riluzole on
dyskinesia and the duration of the ON state in patients with Parkinson
disease (PD). The authors studied 16 PD patients with levodopa-induced
dyskinesia. All patients initially received an apomorphine dose intended to
induce the motor function benefit (ON state) generally accompanied by
dyskinesia. They evaluated the patients during the OFF and ON states using
the UPDRS-III, UPDRS-IV, and Larsen scales, and measured the duration of the
ON state. Patients were randomly assigned to receive either riluzole (50 mg
bid) or placebo for 7 consecutive days (8 patients in each group). The
authors did not interrupt previously prescribed medication. Following the
7-day period, they carried out similar evaluation procedures before and
after another apomorphine challenge. Mean UPDRS-IV scores were 6.1 points
and 6.0 points before and after riluzole therapy respectively. For the
placebo group, the scores were 6.9 points and 6.6 points for the initial and
final evaluations respectively. Larsen scale had mean scores of 9.2 points
and 9.9 points for the pre- and postriluzole periods, and 10.2 points and
9.6 points for pre- and post-placebo evaluations respectively. The ON state
was 33.5% lengthier after 7 days of riluzole and 28.0% lengthier after
placebo. They could not find any statistical differences between the 2
groups. Short-term riluzole administration in PD patients was not able to
reduce apomorphine-induced dyskinesia but could extend the ON state
duration, although this did not reach statistical significance.

PMID: 15090933
####

Tetrabenazine  (2005)
Tetrabenazine is available in some European markets and Australia as
XENAZINE(R) and in Canada as NITOMAN(R) for the treatment of hyperkinetic
movement disorders. Although currently an investigational drug in the U.S.,
tetrabenazine can have a profound effect on chorea, with many patients
demonstrating marked to good improvement. Side effects can include
drowsiness, insomnia, akathisia and depression.
Prestwick Pharmaceuticals
Prestwick Pharmaceuticals, Inc. is an emerging specialty pharmaceutical
company that focuses on treatments for CNS disorders. The company has
multiple product candidates in clinical development for Huntington's
Disease, Parkinson's disease and schizophrenia.
Prestwick recently announced positive Phase III results of the
investigational drug tetrabenazine for chorea associated with Huntington's
Disease. The company anticipates filing a New Drug Application (NDA) for
tetrabenazine with the U.S. Food and Drug Administration (FDA) in the near
future. Prestwick was granted both fast track and orphan designation by the
FDA for tetrabenazine as a therapy for chorea associated with Huntington's
Disease.
# # #
Source: 9th International Congress of Parkinson's Disease
Peggy
----- Original Message -----
From: Hilary Blue
To: [log in to unmask]
Sent: Tuesday, March 15, 2005 8:26 AM
Subject: Re: (my progress report) / AMANTADINE... ? / calibration


Ariela,

About six years ago,, my dyskinesia became so bad that I volunteered
for  DBS surgery - then still  in  the pre-trial phase.  But before my
turn came,  I read on this list about someone who  took amantadine
 and how it   almost miraculously cured his dyskinesia. I persuaded my
doctor to let me try it, and within 24 hours I no longer matched the
requirements for volunteering for the DBS trial!

Now, 6 years later, it is losing its effect, and I am left with
increasing  dyskinesias and dystonias.  I have taken every  PD
 medication that there is, and the best response was with amantadine.
 Until recently I was taking eldepryl too, but that seemed to lose its
effect, so I am sticking to my sinemet and amantadine and eagerly
waiting to see what is new coming down the pipeline. (Rasagaline, do I
hear you?)

hilary blue






ariela wrote:

>rick,
>
>a new movement disorder neurologist we've now been seeing at mount sinai in
new york has told us that amantadine is the drug of choice for dealing with
dyskinesia.     it's the first i hear this take about this little-used
drug....     but we're still keeping this option open as my PWP is now
trying stalevo (after 4 years on sinemet + requip).     he's having an awful
time just getting calibrated -- he moves instantaneously between long and
painful freezes to awful states of badly spastic dyskinesia.   there's just
never a simple 'quiet,' 'calibrated' time.      it goes without saying that
the dosages and frequency have been tweaked and re-tweaked, to not much
avail...  :(
>
>does it sound familiar to you, or anyone on the list?   can anyone please
share what you do/have done/know about it?    (
>
>many thanks,
>ariela
>
>====
>
>>But I just figure it might be worth a little extra pain in order to put
off those nasty
>>diskenesias....
>>
>>Enjoy!
>>Rick McGirr
>>
>
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